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Racial differences in blood pressure control: potential explanatory factors
Hayden B Bosworth1, Benjamin Powers, Janet M Grubber
1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center (152), Durham, NC, USA. hayden.bosworth@duke.edu
Journal of General Internal Medicine
|February 22, 2008
Summary
Racial disparities in blood pressure control exist, with African Americans experiencing poorer outcomes. Factors like medication nonadherence and stress contribute to this gap, highlighting potential areas for intervention.
Area of Science:
- Cardiovascular Health
- Health Disparities Research
- Clinical Hypertension Management
Background:
- Racial disparities in blood pressure (BP) control are a significant public health concern.
- Understanding the factors contributing to these disparities is crucial for developing targeted interventions.
- Previous research indicates differences in BP control between racial groups, but underlying reasons require further investigation.
Purpose of the Study:
- To identify potential explanatory factors for observed racial differences in blood pressure control.
- To investigate the association between demographic, clinical, and psychosocial variables and BP control in hypertensive patients.
- To examine the role of medication nonadherence, stress, and age in racial disparities in hypertension management.
Main Methods:
- Cross-sectional study design involving 608 hypertensive patients (50% African American, 50% white).
- Data collected included clinical, demographic, and psychosocial variables.
- Blood pressure control was assessed, and factors associated with inadequate control were analyzed.
Main Results:
- African Americans were more likely than whites to have inadequate BP control (49% vs. 34%).
- Factors associated with poor BP control included older age, medication nonadherence, longer hypertension duration, high stress, worry about hypertension, and medication side effects.
- Adjusted analyses confirmed poorer BP control in African Americans (OR=1.5), with medication nonadherence, worry, and older age remaining significant factors.
Conclusions:
- Several factors, including age, medication nonadherence, and worry about BP, partially explain the racial disparity in hypertension control.
- Medication nonadherence is a key modifiable factor that could be targeted to reduce racial disparities in BP control.
- Interventions addressing these factors may improve BP control and reduce health inequities in hypertensive populations.
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